You are caring for a young patient who is being discharged with a prescription for an inhaler. Upon asking the patient if he knows how to use the inhaler, he says, "Yes, I do." Tell me how you proceed.
Although most medications are dispensed with administration instructions at the pharmacy, many patients do not understand how to administer to themselves which results in their misuse. For medications such as beta agonists or corticosteroids which are administered via inhaler, misusing the inhalant device could mean the patient is not getting enough medication to help manage their condition. This is common for all medications which is why it is important for nurses to ensure patients understand how to properly take their medications before discharge. The interviewer is asking this question to determine if the candidate would ensure the understands how to use the inhaler before discharging him, rather than simply taking the patient's word for it. To effectively answer this question, the candidate should describe, in detail, how they would verify that the patient understands how to use the inhaler. A more successful answer to this question would include a specific example from the candidate's nursing career where they helped educate a patient on their medication regimen before discharge or how they developed patient education protocols or materials for their unit or organization.
"Even if the patient was adamant that he knew how to use the inhaler, I would get him to demonstrate how he uses an inhaler, either by using a teaching tool or by simply using an unrelated object to mock up the situation. Inhalers are more difficult to use than most people realize, and so many patients make mistakes when administering their inhaled medications to themselves. But this isn't only limited to inhaled medications, I always make sure my patients understand their medication regimen, and after I go over it with them, I have them demonstrate it to me or repeat it back to me, to ensure they understand. This is something I have always done in my nursing career and will continue to do so before I discharge my patients."
"Even if a patient assures me that he knows how to use his inhaler, I will ask him to demonstrate or explain its use to me. If we have a dose of his inhaler due soon, I will verbally review the steps of using his inhaler, and then I will ask him to show me using it. If he won't be due for a dose of his inhaler before discharge time, I will use the teach-back method, in which I will ask him to verbally 'teach me' to use his inhaler. It's important that patients can administer their medications to themselves upon discharge, and I always make sure to review patients' medications with them and check for understanding before discharge. I had a similar scenario with a patient who was being discharged with a new insulin pen. The patient told me he understood how to load the needle onto the pen, but when I asked him to demonstrate, he wasn't able to do it. We practiced a few times to make sure he understood the entire process, and he then was able to put the pen and needle together prior to discharge."
Community answers are written by other candidates practicing this set. Reading how others frame the same question is one of the fastest ways to sharpen your own.
Anonymous Answer
I would ask the patient if he is familiar with an inhaler and what it does. This allows for the patient to show what they know about their own disease process, even if they are young. I would ask the patient if he has any questions on the medication or the device and see if I can clarify anything he doesn't understand. I would then ask the young patient to demonstrate how to use it prior to discharge. Lastly, I would add any additional information on how to use it and things to look out for when using an inhaler.
Cindy's Feedback
Great. This question is seeking an answer that reveals all the ways you would ensure that the patient knew how to use the inhaler. You covered multiple methods which is a convincing approach.
Anonymous Answer
In this case, I would apply the teach-back method and ensure that the patient knows how to use it .
Chad's Feedback
The teach-back method would be a great approach to take in this situation. However, the interviewer will be seeking a more detailed response describing how exactly you would verify that the patient understands how to use the inhaler. Are you able to describe the steps involved with implementing the teach-back method? If possible, cite a specific example from your nursing career of a time you helped educate a patient on their medication regimen before discharge.
Anonymous Answer
Want the patient to demonstrate that they do in fact know how to use the inhalers correctly. Gather the supplies and have the patient demonstrate how to use the puffer. If not correct provide guidance and additional teaching. With younger patients, I like to print off instructions to go home with and involve a parent in teaching as well. Or better yet have the patient teach their parent how to do it. I like to do the teach-back method where you show them one step and they repeat back how to do it. Then you have them show you combining all the steps. Visual aids and hands-on teaching I find to be the most effective with patients. I also recommend if they are at home and have any concerns they can always call the 811 nurses line.
Cindy's Feedback
Great! The additional context works! It tells the interviewer why you are taking these steps. Good job.
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